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Fact Sheet No. Food and Nutr i t ion Ser ies|Health
by J. Anderson and L. Young*
History is full of references of the use of sweeteners. One of
the earliest is a Spanish drawing of a man harvesting honey, dated
around 7000 B.C. We know that the Egyptians kept bees for honey, as
depicted in tomb drawings as early as 2600 B.C. Research proves
something that most of us are already aware of; people are born
with a desire for sweet taste.
Sugar provides quick energy and a concentrated source of
calories. This benefit has its downside, however, because consuming
too many calories, regardless of the source, contributes to
obesity. And sugar is a major contributor to tooth decay.
Nutritive SweetenersSugars. Sugars (saccharides) are
widespread in nature and are the building blocks of
carbohydrates monosaccharides, disaccharides and polysaccharides.
The monosaccharides, glucose, fructose, and galactose are composed
of just one sugar molecule, and are known as the simple sugars.
Glucose and fructose are abundant in fruits, honey, and processed
foods. Galactose is found only in milk.
Disaccharides are formed from two simple sugar units that are
chemically attached, and include sucrose, lactose and maltose.
Sucrose comes from sugar beets or sugar cane, and is more
commonly known as table sugar. Sucrose is composed of the two
simple sugars, glucose and fructose. It is the most abundant sugar
in nature, important for its palatability, availability, low cost,
and simplicity of production. Additional products from the
refinement process of sucrose are molasses, brown sugar, and
confectioners sugar.
Lactose also is referred to as milk sugar. Lactose is made of
the two simple sugars
Quick FactsThedesirabletasteforsugarisinnate.
Thebodydoesnotdistinguishbetweennaturalsugarsandprocessedsugars.
Allsugarscontainfourcaloriespergram.
Theaveragepersonconsumesover100poundsofsugarperyear.
Sugarisnaturalandnontoxic.Theonlydiseasedirectlyassociatedwithsugaristoothdecay.
TheDietaryGuidelinesadviseAmericanstousesugaronlyinmoderation.
Sugar and Sweeteners 9.301
ColoradoStateUniversityExtension.9/98.Revised5/10.
www.ext.colostate.edu
glucose and galactose. Maltose, two glucose units, is the result
of the fermentation of the starch in grains by yeast or enzymes, as
in bread-making or brewing.
The polysaccharide family includes starch, cellulose, pectin,
and glycogen. These complex carbohydrates are chains of glucose
molecules. Starch, cellulose, and pectin are found in plants.
Glycogen is the storage form of glucose for humans and animals.
The simple sugars and many foods with large amounts of simple
sugars provide energy (calories), but contain few other nutrients.
They may replace other foods that are high in vitamins, minerals
and other important nutrients in the diet. However, while fruits
are sweet because of the sucrose and fructose they naturally
contain, they are excellent sources of vitamins and fiber. Starch
is abundant in nutrient-rich foods such as vegetables, grains,
beans, and potatoes. Carbohydrates, regardless of the form, are
important for providing energy to the body.
Corn Syrup. Corn syrup is a glucose derivative of corn starch,
popular in the brewing, canning, and baking industries because it
lends texture and body to these types of products.
High-fructose corn syrup (HFCS) takes the processing of corn
syrup one step further, by converting much or all of the glucose to
fructose. The resulting product is sweeter than sucrose, allowing
less of it to be used. HFCS is the main nutritive sweetener in the
soft drink industry.
Sugar Alcohols. Sugar alcohols are sometimes used as a
substitute for sucrose. Mannitol, sorbitol, and maltitol occur
naturally in fruits. Xylitol is a normal intermediate product in
the metabolism of carbohydrates in fruits and vegetables. Sugar
alcohols add bulk and texture to food such as chewing gum and hard
candies. Because they are metabolized by the body more slowly than
sucrose, they are useful in foods for people following special
diets, such as a diabetic diet.
*J. Anderson, Ph.D., R.D., Colorado State University Extension
food and nutrition specialist and professor; and L. Young, M.S.,
former graduate student. 5/2010
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Metabolism and DigestionThe body is unable to distinguish
between natural sugar found in fruit, honey or milk, or
processed sugar. All sugars are digested in the same manner.
Although carbohydrate digestion starts in the mouth, the small
intestine is the major area of digestion and absorption. Here,
polysaccharides are broken down to disaccharides and then
monosaccharides, which are shunted to the liver. Both the liver and
small intestine are able to convert the monosaccharides galactose
and fructose, to glucose. Energy needs of the body determine if the
glucose will be shipped out to the brain, muscles, kidneys or heart
for immediate use, or stored as glycogen in the liver or skeletal
muscles for later use. Glucose that exceeds immediate need and
temporary storage capacity is converted to fat and stored.
While all sugars contribute four calories per gram, some foods
contain more concentrated sources of calories than others. For
example, a teaspoon of table sugar contains 16 calories. Honey is a
more dense calorie source a teaspoon contains 22 calories. But a
teaspoon of orange juice or applesauce has just four calories, and
also contains vitamins, minerals, and fiber.
Food LabelsThe Dietary Guidelines advise to
consume sugar only in moderation, but much of the sugar in our
diets is hidden, as it is already added to the foods we eat. By
reading food labels and becoming more aware of the sugar content of
every day foods, it is easier to reduce the total amount of sugar
in our diets. Food labels list ingredients in order of amount
present in the food, from most to least. If sugar is listed as one
or is more of the first three
ingredients, the product is considered high in sugar.
Some foods contain several different types of sugar in various
forms. Table 1 lists different types of sugars.
Alternative Sweeteners Alternative sweeteners are
essentially
calorie-free and at least 30 times sweeter than sucrose. There
currently are six alternative sweeteners approved for use in the
United States: acesulfame-K, aspartame, neotame, saccharin, stevia,
and sucralose. Cyclamates were considered safe for use at one time
in this country, but were banned in the 1970s.
Acesulfame-K. Acesulfame-K is similar to aspartame in sweetening
power, but holds up better to heat and costs less. Marketed as
Sunette, Sweet One and Diabetisweet the sweetener was approved by
the Food and Drug Administration (FDA) in 1988 for limited use in
products such as chewing gums and dry beverage mixes. In 1998, the
FDA approved acesulfame-K for use in soft drinks.
Aspartame. Commercially available as Equal, Nutrasweet and
Spoonful (a product designed to measure like sugar), aspartame is
composed of two naturally occurring amino acids (the building
blocks of protein) phenylalanine and aspartate. Aspartame has a
flavor similar to sucrose, and also functions as a taste
intensifier and enhancer. Aspartame is 200 times sweeter than
sucrose and has no aftertaste. After nearly two decades of safety
testing, aspartame was approved by the FDA in 1981 for use in a
variety of products, as a table-top sweetener and in carbonated
beverages. In July 1993, approval was made for use in hard and soft
candies, baked goods and mixes, nonalcoholic beverages and malt
beverages. A packet of this sweetener is equivalent in sweetness to
two teaspoons of sugar (32 calories), for just four calories.
Products that contain aspartame must carry a warning to people
with phenylketonuria, a rare genetic disorder that prevents proper
metabolism of phenylalanine. Unlike the alternate sweeteners
saccharin, acesulfame K, neotame and sucralose, which have no
nutritional value, aspartame contributes calories. This is due to
the fact that it can be used by the body just as any other
protein,
but the amounts are so small that its caloric value is
insignificant. Aspartame does not contribute to tooth decay.
Neotame. Neotame is 7,000 to 13,000 times sweeter than sugar. It
was approved for use as a general-purpose sweetener by the FDA in
2002. To date, there are no consumer products available containing
neotame.
Saccharin. Saccharin actually is a petroleum derivative that is
200 to 700 times sweeter than sucrose. It is sold as a white powder
for use as a table-top sweetener, and used in a variety of foods
such as beverages, jams, and baked goods. It has a bitter
aftertaste at high concentrations. Despite controversy over its
safety, it remains on the generally-recognized-as-safe (GRAS)
list.
Stevia. Stevia is a plant native to Central and South America.
Although most manufacturers and consumers refer to the sweetener as
Stevia, the sweetening compound is actually a plant extract called
Rebaudioside A (Reb A). Reb A is 200 to 300 times sweeter than
sucrose. The FDA approved GRAS status to 95 percent pure Reb A in
December of 2008 for its use as a sweetener in food and beverages.
The World Health Organizations Joint Expert Committee on Food
Additives also deemed highly pure Reb A safe for use as a general
sweetener in 2008. Reb A is sold as a tabletop sweetener as
PureVia, Truvia, SUN CRYSTALs, and Stevia Extract IN THE RAW. A
limited number of commercially sold beverages are sweetened with
Reb A.
Sucralose. Approved by the FDA in 1998, sucralose is the only
alternative sweetener made from sugar. It is 600 times sweetener
than sucrose (1.6 calories per teaspoon). Sucralose is derived from
sugar through a patented, multi-step process that creates an
extremely stable substance unable to be absorbed by the human body.
It is excreted in the urine virtually unchanged. Manufactured under
the
Table 1. Types of sugars.
dextrose lactosesucrose levulosefructose
maltoseevaporatedcanejuice turbinadocornsyrup mannitolmaplesugar
milksugarglucose xylitolgranulatedsugar maltitolmolasses
honeysorbitolevaporatedcanejuiceinvertsugarbrownricesyruphighfructosecornsyrup(HFCS)
Alternativesweetenersareessentiallycalorie-freeandatleast30timessweeterthansucrose.There
currently are six alternative sweeteners approved for use in the
United States: acesulfame-K, aspartame, neotame, saccharin, stevia,
and sucralose.
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name Splenda, sucralose can be found as a tabletop sweetener and
in a variety of products including desserts, confections, and
nonalcoholic beverages. Sucralose does not contribute to tooth
decay.
Not Approved in the U.S.Cyclamates. Cyclamates are 30 times
sweeter than sugar, leave little aftertaste, and are heat
stable. Cyclamate was banned in the U.S. in 1970 after a study
where it was fed to rats in combination with saccharin implicated
it as a possible cancer-causing agent. (Subsequent research failed
to replicate this finding.) Cyclamates have been pending
re-approval by the FDA since 1982, and are approved for use in 50
other countries including Canada. Use of cyclamates in Canada is
restricted to table-top sweeteners and pharmaceuticals.
Sugar and Your HealthObesity. Eating sugar does not cause
obesity. Obesity is the result of consuming calories in excess
of need, regardless of their source. Diets high in added sugars are
often high in excess calories as well. By reducing the amount of
sugar, and thus calories, in your diet, it is possible to lose
weight without compromising intake of essential nutrients.
Diabetes. A diet that is high in sugar has not been proven to
cause diabetes. The most common type of diabetes occurs in
overweight adults.
Heart Disease. Although sugar is not a direct risk factor for
heart disease, the American Heart Association (AHA) published
guidelines to limit added sugar intake in August of 2009. The
guidelines state that no more than half of a persons
discretionary calories should come from added sugars. For the
average adult woman this equals five teaspoons of sugar (80
calories) per day and nine teaspoons (180 calories) per day for the
average adult man. The primary risk factors for heart disease are
high blood cholesterol, obesity, smoking, inactivity, and being
male.
Hyperlipidemia. Research has demonstrated a link between diets
high in glucose, fructose and sucrose and high blood triglycerides
(fat) and cholesterol. Diets that replace fat with simple sugars
also lower high-density lipoproteins (HDL), the good cholesterol.
Resent evidence suggests that diets high in added sugars may lead
to an increase in blood pressure as well. However, studies results
have been inconsistent and this link is still under
investigation.
Tooth Decay. We know that sugars and starches are major
contributors to tooth decay. Risk for developing dental caries
(cavities) goes up with the frequency of consumption of foods
containing these nutrients, and the longer they remain in the mouth
without brushing the teeth.
Sugars in the mouth are digested by bacteria on the tooth
surfaces. Acid produced by the bacteria causes the enamel to break
down, leading to cavities and gum disease. Sugar that remains on
the teeth is actually of more concern than amount of sugar
consumed. The acid produced by the bacteria lasts for about 20
minutes each time carbohydrate is eaten. This is true regardless of
which carbohydrate-containing food is eaten. Bacterial acid
production is present whether the carbohydrate is glucose from
concentrated sweets, starches, lactose from milk, or fructose from
fruit. The stickiness of the sugar also supports bacterial
growth.
A few tips for healthier teeth and gums: limit between-meal
snacks that contain
sugars and starches. brush with fluoride toothpaste and
floss
regularly. ask your dentist about fluoride
supplements, especially for children. dont use a nursing bottle
with any
beverage other than water for a pacifier. For more information,
see fact sheet
9.321, Nutrition and Dental Health.
Reducing Sugar IntakeLearn to enjoy foods that are naturally
sweet, without added sugar. Below are shopping and cooking
suggestions to help meet the Dietary Guidelines goal of using
sugars in moderation.
In the kitchen: Use 2/3 to 3/4 cup of sugar for each cup
in a recipe. Replace omitted sugar with an equal
amount of non-fat dry milk to increase nutritional value.
Use spices and herbs such as cinnamon, nutmeg, cloves and ginger
to enhance the flavor of foods.
Make homemade sauces and toppings with less sugar.
Use dried or fresh fruit or frozen fruit juice concentrates to
sweeten cereals and baked goods instead of table sugar.
Shopping: Take your time. Read labels not only
to reveal hidden sugar, but to gain information on the overall
nutritional value of foods. See Table 2 for hidden sugars in
foods.
Buy fresh fruits or fruit packed in water. Buy fewer foods high
in sugar such
as cookies, candies, soft drinks, and prepared baked goods.
Be aware dont replace foods high in sugar with foods high in fat
and sodium.
Eatingsugardoesnotcauseobesity.Obesityistheresultofconsumingcaloriesinexcessofneed,regardlessoftheirsource.Dietshighinaddedsugarsareoftenhighinexcesscaloriesaswell.Byreducingtheamountofsugar,andthuscalories,inyourdiet,itispossibletoloseweightwithoutcompromisingintakeofessentialnutrients.
Afewtipsforhealthierteethandgums:
Limitbetween-mealsnacksthatcontainsugarsandstarches.
Brushwithfluoridetoothpasteandflossregularly.
Askyourdentistaboutfluoridesupplements,especiallyforchildren.
Dontuseanursingbottlewithanybeverageotherthanwaterforapacifier.
Formoreinformation,seefactsheet9.321,NutritionandDentalHealth.
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Table 2. Hidden sugars in foods. Portion Size Approximate Sugar
Equivalent SweetenersHoney 1tsp 11/2tspTablesugar 1tsp
1tspBeverages Orangesoda 12oz 12tspCola 12oz 10tspKool-Aidw/sugar
12oz 81/2tspTonicwater 12oz 8tspCandy MilkyWay 2.1oz 9tspHardcandy
4pcs 31/2tspBubblegum 1pc 2tspDairyLowfatyogurt,fruit 1cup
11tspLowfatyogurt,plain 1cup 4tspBaked GoodsOatmealcookies 2
1/2tspGrahamcrackers 2 1tspTwinkies 1pkg 81/2tspSpongecake 1slice
4tspCanned Fruit Pears,hvy.syrup 1/2cup 5tspPears,lt.syrup 1/2cup
31/2tspPears,water 1/2cup 11/2tsp
ColoradoStateUniversity,U.S.DepartmentofAgricultureandColoradocountiescooperating.CSUExtensionprogramsareavailabletoallwithoutdiscrimination.Noendorsementofproductsmentionedisintendednoriscriticismimpliedofproductsnotmentioned.
Snacks: Unsweetened, lowfat yogurt flavored
with nutmeg, cinnamon or fresh fruit. Popcorn, raw vegetables or
lowfat
cheese instead of cookies and candy. Graham crackers or vanilla
wafers
instead of cookies. Top cakes with fresh fruits instead of
frosting. Drink 100 percent fruit juices, water
or unsweetened sparkling and mineral waters, instead of
Kool-Aid, fruit flavored drinks, or soda pop.
ReferencesAmerican Dietetic Association. Position of
the American Dietetic Association: Use of nutritive and
nonnutritive sweeteners. J Am Diet Assoc. 2004;104(2):255-75.
FDA: www.fda.gov.Franz, M.J., Maryniuk, M. D. Position of
The American Dietetic Association:
Use of nutritive and non-nutritive sweeteners. J. Am. Dietetic
Assn. 93 (7), 816-821, 1993.
Geise, J. H. Alternative Sweeteners and Bulking Agents. Food
Technology. pp. 114-126. 1993.
Johnson, R.K., Appel, L.J., Brands, M., et al. Dietary sugars
intake and cardiovascular health: a scientific statement from the
American Heart Association. Circulation. 2009; 120:1011-20.
National Cancer Institute: www.cancer.govUnited States
Department of Agriculture,
Human Nutrition information Service. Dietary Guidelines and Your
Health. Publication 1490. 1992.
Upton, J. Hot topic: Stevia. American Dietetic Association.
2009. Available at:
www.eatright.org/About/Content.aspx?id=6826&terms=stevia.
Whitney, E. N., Roles, S. R. Understanding Nutrition. pp.
93-130. 1993.